Health
Advisory
MULTIPLE STATES INVESTIGATING A LARGE OUTBREAK OF
E.COLI O157:H7 INFECTIONS

The Division of Public Health is forwarding this Health Advisory from the Centers for Disease Control and Prevention. To contact DPH
about this Health Advisory, call 1-888-295-5156. This number is answered during normal business hours, and during non-business hours for
emergencies.

This is an official
CDC Health Alert

Multiple States Investigating a Large Outbreak of E. coli O157:H7 Infections

Public health officials in multiple states, with the assistance of the Centers for Disease Control and Prevention, are investigating a
large outbreak of E. coli O157:H7 infections. Thus far, 50 cases with isolates demonstrating pulsed-field gel electrophoresis (PFGE) CDC
PulseNet pattern number EXHX01.0124, as determined by Xba restriction enzyme DNA digestion, have been reported from CT (1), ID (3), IN
(4), MI (3), OR (5), NM (2), UT (11), WI (20). Eight patients developed the hemolytic uremic syndrome (HUS) and one patient died. Most
cases are recent: for those with known illness onset, the range of onset is 08/25/2006 to 09/03/2006. The outbreak is likely ongoing.

Preliminary findings from case interviews indicate that pre-packaged spinach is the most likely source. Additional investigation is
necessary to determine the brand or brands of pre-packaged spinach involved. State and CDC investigators are working with FDA to quickly
gather information to take action to protect the public. The FDA advises that consumers not eat bagged fresh spinach at this time.

The E. coli O157:H7 bacterium causes diarrhea that is often bloody and accompanied by abdominal cramps, but fever is absent or mild. The
illness typically resolves within a week. However, some people, especially young children and the elderly, develop the hemolytic uremic
syndrome, or HUS.

E. coli O157:H7 cases should be reported rapidly to the appropriate local and state public health officials, and isolates should be
forwarded to state public health laboratories for rapid PFGE analysis. We request state officials report cases demonstrating the outbreak
PFGE pattern to the Enteric Diseases Epidemiology Branch (Thai-An Nguyen (ten9@cdc.gov, 404-639-0776) ASAP.

NOTE: The CDC HAN web site has been relocated. The link to the new site location is: http://www2a.cdc.gov/HAN/ If you maintain or contribute to a web
site that links to the CDC HAN web site you should update the link. Also, to ensure the widest dissemination of this change it would be
appreciated if you would distribute this notification as appropriate. Thank you!